Yesterday I was asked if drinking codeine cough syrup mixed with Sprite was "the same thing I was talking about". I had just finished a presentation to an elite Baltimore private high school about the opioid epidemic. The thrust of the presentation was that the most common way that people find themselves addicted to opioids is by starting with prescription pain pills. Call me naive, but I did not realize that kids were starting even further up the chain by drinking "lean".

According to urban lore, "lean", "purple drank", "dirty sprite", originated in Houston in the late 1960s, but was popularized by L'il Wayne over the last few years. In June of 2016, Lil Wayne's plane had to make an emergency landing to treat the rapper for an opioid overdose.

Most disturbing, however, was that after the high school presentation, I talked to middle school kids. When I asked if any of them had heard of people mixing cough syrup and Sprite, they all giggled and confirmed that they were well aware of the trend.

There has been recent press lately about easy access to prescription pain pills in American medicine cabinets, but I have not seen anything about the lean fad. It strikes me as similar to marshmallow flavored vodka, another favorite of the teen set. Make something illicit easy to consume and kids will flock: a simple recipe.

The brain can't tell the difference between opioids from lean, pain pills or heroin. It's all the same. The brain will respond how it will respond, by building tolerance. Once that tolerance is built, the brain craves more opioids. Failure to feed the brain what it is asking for results in withdrawal symptoms.

Please discard your excess pain pills and your excess narcotic cough syrup. Your kids may stumble on them or even seek them out if you don't.